Dr. Smith Advises Clinicians on Diagnosing Double-Hit and Triplet-Hit Lymphoma

Sonali M. Smith, MD, Elwood V. Jensen Professor in Medicine, director, Lymphoma Program, University of Chicago Medicine, advises clinicians on diagnosing double-hit and triple-hit lymphoma in patients with diffuse large B-cell lymphoma (DLBCL).

Double-hit and triplet-hit lymphomas are uncommon but not rare, and needs to be looked for in patients diagnosed with DLBCL, Smith says. This subtype is enriched in patients with a germinal center phenotype, as well in those with high-risk features. Smith says that the most important thing is to take a big enough biopsy. If there is a suspicion for an aggressive B-cell lymphoma, Smith advises clinicians to take enough tissue to test for it during initial biopsy.

The most important thing to do when a patient presents with a double-hit lymphoma is to confirm the diagnosis with the pathologist, Smith says. Nuances including amplification, copy number alterations, and mutations can make a difference. Additionally, Smith says that R-CHOP is not going to be sufficient, and clinicians should consider a more intensive therapeutic regimen for these patients.